Clinicopathological patterns of colorectal cancer during the Sudan conflict: a regional oncology center experience

Abstract Background The current armed conflict in Sudan disrupts the health system and affects the referral pathway. It affected the central oncological lead, leading to dependence on the regional oncological centre. This study aimed to assess the demographic and clinicopathological pattern of colorectal cancer in Sudan during the ongoing health center disruption in the regional oncology White Nile Oncological Center. Methods This retrospective, cross-sectional, hospital-based study analyzed data from all colorectal cancer patients who presented it to the White Nile Oncological Center between April 2023 and March 2025. Results A total of 86 patients were included. The mean age was 52.2 ± 13.9 years, and 48.9% of patients with colorectal cancer were aged below 50 years. Males accounted for 52.3% of cases. Most of the patients are from the central states of Sudan. Rectal bleeding (28; 32.6%), symptoms of intestinal obstruction (17; 19.8%), and altered bowel habits (12; 14%) were the most frequently presenting symptoms. Rectosigmoid 28 (32.6%) and the Low rectum in 26(30.2%) were the most involved sites of the colon. The majority of patients had moderately differentiated adenocarcinoma (47, 54.7%). Most of the patients were diagnosed with colorectal cancer, TNM stage I or II disease (59.3%). The liver was the major site for metastasis, found in 16 Patients (18.6%). Conclusion Colorectal cancer during the ongoing Sudan conflict affects relatively young patients at a younger age, with predominance of involvement of left-sided colorectal sites. The findings reflect the central role of decentralized oncology services during healthcare system disruption. Early CRC detection in Sudan requires strengthening regional endoscopy services, expanding pathology facilities, training health providers, and improving screening programs.